Understanding and Addressing Diagnostic Overshadowing in People with Disabilities
This observational study, called "End Diagnostic Overshadowing," is looking at how people with disabilities (PWD) are diagnosed. Sometimes, symptoms in PWD are mistakenly blamed on their disability instead of being recognized as a new health problem. This study aims to understand why these diagnostic errors happen. Researchers will look at existing electronic health records (EHR) of patients aged 3 to 89 years who have specific disabilities and compare their diagnostic processes to those without these disabilities. The study will analyze how EHR prompts and alerts are used, and review medical codes to see if there are differences in how diagnoses are made. The goal is to identify ways to improve diagnostic accuracy for people with disabilities.
- Study design
- This is an observational study involving a large number of participants (120,000 planned enrollment). It compares existing medical records of people with and without disabilities.
- What's involved
- Not specified in the trial record.
- Compensation
- Not stated in the trial record.
- Follow-up
- Data on electronic record use will be collected at 1.5, 2.5, and 3.5 years, and medical code complexity at 4 years. Knowledge questionnaires will be used at 3.5 years.
AI-generated from the public study record. Only the study team can confirm whether you're eligible — confirm details with them before making decisions.
End Diagnostic Overshadowing
At a glance
Conditions
Where it's being run
1 sites across 1 statesStudy leadership
- Sarah H Ailey, PhD RN · PRINCIPAL_INVESTIGATOR · Rush University College of Nursing
Who to contact
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Do you actually qualify for this trial?
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Exclusion
What this trial measures
- Descriptive data on use of electronic record (EHR) decision supports and prompts/alerts1.5, 2.5, and 3.5 years
After implementation of EHR prompts/alerts and decision supports related to diagnostic error, descriptive data will be collected and analyzed on usage.
- Complexity distribution of Evaluation and Management (E/M) Current Procedural Technology (CPT) codes4 years
The percentage of each complexity score for Current Procedural Technology (CPT) Evaluation and Management (E/M) codes will be measured by setting (ED, outpatient, inpatient, preventive care) for differences using Fisher'ss exact tests for patients with disabilities (PWD) aged 3-89 years old with specific disabilities (major mobility impairments, mental health concerns, severe visual impairments/ blindness, severe hearing loss/deafness, and IDD) versus patients aged 3-89 years old without the specific disabilities.
- Knowledge questionnaires3.5 years
Knowledge questionnaires will be developed related to algorithms to detect people with disabilities from 5 specified groups at risk of diagnostic overshadowing, EHR prompts/alerts and decisions supports. Pre and post, the percentage of correct answers will be calculated and compared using ANCOVA.
- Scores on Safer DX Checklist4 years
The Safer Dx Instrument uses a Likert scale to rate the degree of agreement with statement regarding diagnostic processes. Higher scores may indicate a greater likelihood of a diagnostic error or "missed opportunity" for diagnosis.